Recommendations aim to reduce provider burden
Afederal effort to reduce the patientdata reporting burden on providers and align public and private quality efforts has produced its first recommendations. However, neither public nor private insurers are required to implement the final product of the streamlining effort.
The Measures Application Partnership— a group of leading public and private healthcare organizations—released a draft strategy last week that aims to align the various physician performance measures. The group, created by the Patient Protection and Affordable Care Act and led by the National Quality Forum, also aims to align public and private efforts to reduce healthcare-acquired conditions and readmissions.
“There is misalignment of measures within the various programs that are collecting data for particular purposes, and better alignment will lead to less burden on the providers who are reporting the information, as well as more coherent information coming out of that measurement,” said Dr. Tom Valuck, senior vice president for strategic partnerships at the NQF.
Last year’s federal healthcare law required the HHS secretary to consider using only the group’s comments to select and align the various performance measures for public reporting and performance-based payment programs, such as the CMS’ Value-Based Purchasing Program and Physician Quality Reporting System. However, the draft federal quality measures issued so far fit the group’s draft recommendations, Valuck said.
But even if federal insurance programs adopt the eventual recommendations, serious doubts remain over whether private insurers are even capable of following suit.
“Knowing that Medicare can identify a particular hospital-acquired condition through its claims data doesn’t mean that everyone can,” said Nancy Foster, vice president for quality and patient-safety policy at the American Hospital Association. “Knowing that Medicare can alter its payment system in a particular way doesn’t mean that everyone can.”
An example of private insurer obstacles to following the same standards as public insurers came in 2008 when Medicare decided it would cut payments for healthcare services stemming from hospital-acquired conditions. When private insurers attempted to follow suit, some found their billing systems could not identify whether they were even funding such extra care.
Despite those implementation challenges, Foster, who served on a MAP work group, said she is optimistic that the group will ultimately point the way to increased standardization.
“If we all know what the game plan is, then we can work toward achieving it,” she said.